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Suggest treatment for severe pain at the back of the head

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Posted on Fri, 13 Jan 2017
Question: I have been suffering from severe pain in the back left side if my head. Above were my neck meets my skull. It feels like there is a knot there slightly larger than a go!f ball. However, it is not palpable. It is skelital or beneath my skull. I wake up with it in the morning and it doesn't go away. At its worst it is so severe it radiates pain down my neck, around the left side of my head to cause ear, face, temple, eye which feels like nervex and glandular pain in my ne k. Also a line/large vessel size, up the back of my head and usually stops at the top. My pain levels range from 4/5-10. Please advise a to where /what I should consider researching prior to going to the ER. I have had migrains in the past. However, I've never experianced anything like this. These are just below the surface, and does not feel anything like those. I'm currently taking feoricet 4 w/codeine and zanaflex, 2mg with very little success. I'm concerned, with the lack of RX success And the progression of symptoms and pain there is something more serious I should be considering and researching prior to moving forward with a trip to the ER. I' need/wish greatly to to have an inelligent conversational with my physician as to the potentiato diagnosis and p!an of actions
Thank you in advance for you time and efforts XXXXXXX XXXXXXX

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Answered by Dr. Albana Sejdini (4 hours later)
Brief Answer:
Detailed below...

Detailed Answer:
Hello XXXXXXX

I read your message carefully and understood your concern.

I see you have had migraines before. Treatment that the doctor recently gave you is all about treating the migraines.
Fioricet is a combination of some pain relievers and it is used to treat the tension headaches that are mostly caused by muscle contractions. Zanaflex is used to relax the muscles and Topomax is a drug that helps in preventing migraine attacks but does not relief the pain once the migraine crisis has already begun.

The fact that these drugs are not helping you means that the cause is hidden somewhere else not in any migraine episode.

You have pain only on the left side of your head in the back with radiates down in the neck and all around of your left side of head including the left ear, face, temple, and eye. Also, you have the sense that some mass is beneath your skull but its is not palpable. You mention also a large vessel that starts on your back and stops on the top of your head.

It is very important to understand what makes your pain worse during the day. If the movement of your head or neck increases the pain this means that the problem maybe it is not only in the head.

First thing, that comes in my mind, is cervical headaches which are caused by the pathologic developments in the neck tissues or cervical spine. The result is upper neck pain referred to temporal and facial regions. The main cause is neck disorders or lesions.

It needs to be identified properly and treated early because the symptoms aggravate as the time passes and the painkiller drugs do nothing to correct the cause.

A detailed neck examination is quite necessary followed by a CT scan and if necessary an MRI must be done to take a better look to soft tissues. There are other causes to take into account as well like disorders of blood vessels (arteritis) and infection. An aneurysm needs to be evaluated as it can be dangerous.

If treated properly, everything normalizes within 3 months. First, a neurologist must see you and do a neurological examination which consists in testing some moves and reflexes than you will go for radiological examination.

I hope this is helpful for you.
Dr.Albana
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Albana Sejdini

General & Family Physician

Practicing since :2006

Answered : 7194 Questions

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Suggest treatment for severe pain at the back of the head

Brief Answer: Detailed below... Detailed Answer: Hello XXXXXXX I read your message carefully and understood your concern. I see you have had migraines before. Treatment that the doctor recently gave you is all about treating the migraines. Fioricet is a combination of some pain relievers and it is used to treat the tension headaches that are mostly caused by muscle contractions. Zanaflex is used to relax the muscles and Topomax is a drug that helps in preventing migraine attacks but does not relief the pain once the migraine crisis has already begun. The fact that these drugs are not helping you means that the cause is hidden somewhere else not in any migraine episode. You have pain only on the left side of your head in the back with radiates down in the neck and all around of your left side of head including the left ear, face, temple, and eye. Also, you have the sense that some mass is beneath your skull but its is not palpable. You mention also a large vessel that starts on your back and stops on the top of your head. It is very important to understand what makes your pain worse during the day. If the movement of your head or neck increases the pain this means that the problem maybe it is not only in the head. First thing, that comes in my mind, is cervical headaches which are caused by the pathologic developments in the neck tissues or cervical spine. The result is upper neck pain referred to temporal and facial regions. The main cause is neck disorders or lesions. It needs to be identified properly and treated early because the symptoms aggravate as the time passes and the painkiller drugs do nothing to correct the cause. A detailed neck examination is quite necessary followed by a CT scan and if necessary an MRI must be done to take a better look to soft tissues. There are other causes to take into account as well like disorders of blood vessels (arteritis) and infection. An aneurysm needs to be evaluated as it can be dangerous. If treated properly, everything normalizes within 3 months. First, a neurologist must see you and do a neurological examination which consists in testing some moves and reflexes than you will go for radiological examination. I hope this is helpful for you. Dr.Albana